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Background Antenatal care (ANC) is an essential intervention to improve maternal and child health. In Nigeria, no population-based studies have investigated predictors of poor receipt of components and uptake of ANC at the national level to inform targeted maternal health initiatives. This study aimed to examine factors associated with inadequate receipt of components and use of ANC in Nigeria. Methods The study used information on 20 405 singleton live-born infants of the mothers from the 2013 Nigeria Demographic and Health Survey. Multivariable logistic regression analyses that adjusted for cluster and survey weights were used to determine potential factors associated with inadequate receipt of components and use of ANC. Results The prevalence of underutilization and inadequate components of ANC were 47.5% (95% CI: 45.2 to 49.9) and 92.6% (95% CI: 91.8 to 93.2), respectively. Common risk factors for underutilization and inadequate components of ANC in Nigeria included residence in rural areas, no maternal education, maternal unemployment, long distance to health facilities and less maternal exposure to the media. Other risk factors for underutilization of ANC were home births and low household wealth. Conclusion The study suggests that underutilization and inadequate receipt of the components of ANC were associated with amenable factors in Nigeria. Subsidized maternal services and well-guided health educational messages or financial support from the government will help to improve uptake of ANC services.

Background Depression is a leading source of morbidity and health loss in Australian women. This study investigates the determinants of antenatal depressive symptoms and postnatal depressive symptoms in an Australian population, including people from culturally and linguistically diverse (CALD) backgrounds. Method The study used a retrospective cohort of mothers of all live births in public health facilities in 2014 (N = 17,564) within South Western Sydney Local Health District and Sydney Local Health District in New South Wales, Australia. Prevalence of antenatal and postnatal depressive symptoms were estimated for the cohort. Multivariate logistic regression models were conducted to investigate the sociodemographic, psychological and health service determinants of antenatal and postnatal depressive symptoms, measured using the Edinburgh Postnatal Depression Scale (EPDS). Results The prevalence of antenatal and postnatal depressive symptoms was 6.2% and 3.3% of the cohort, respectively. Significant risk factors for maternal depressive symptoms during pregnancy were, a lack of partner support, history of intimate partner violence, being from the CALD population and low socioeconomic status. Self-reported antenatal depressive symptoms were strongly associated with postnatal depressive symptoms. Risk factors for postnatal depressive symptoms were similar to those for antenatal depressive symptoms, as well as assisted delivery. Conclusion Factors relating to demographic and psychosocial disadvantage were associated with subsequent antenatal and postnatal depressive symptoms in New South Wales, Australia. Our study suggests that screening for probable depression and timely referral for expert assessment of at-risk mothers may be an effective strategy to improve maternal mental health outcomes.

Background Diarrhoea is a leading cause of child mortality in Tanzania. The association between optimal infant feeding practices and diarrhoea has been reported elsewhere, but the evidence has been limited to promote and advocate for strategic interventions in Tanzania. This study examined the association between infant and young child feeding (IYCF) practices and diarrhoea in Tanzanian children under 24 months. Methods The study used the Tanzania Demographic and Health Survey data to estimate the prevalence of diarrhoea stratified by IYCF practices. Using multivariable logistic regression modelling that adjusted for confounding factors and cluster variability, the association between IYCF practices and diarrhoea among Tanzanian children was investigated. Results Diarrhoea prevalence was lower in infants aged 0–5 months whose mothers engaged in exclusive breastfeeding (EBF) and predominant breastfeeding (PBF) compared to those who were not exclusively and predominantly breastfed. Infants aged 6–8 months who were introduced to complementary foods had a higher prevalence of diarrhoea compared to those who received no complementary foods, that is, infants who were exclusively breastfed at 6–8 months. Infants who were exclusively and predominantly breastfed were less likely to experience diarrhoea compared to those who were not exclusively and predominantly breastfed [adjusted odds ratio (AOR) 0.31, 95% confidence interval (CI) 0.16–0.59, P

China has launched an ambitious strategy to develop a national high-speed rail (HSR) system with a total distance of 38,000 km by 2025. The massive development of HSR has not only facilitated the improvement of interregional accessibility, it also substantially stimulated urbanization and urban expansions across various cities. This paper investigates fundamental questions pertaining to change in land use related to HSR in China. First, does the development of HSR play a role in promoting change in urban land use structure? Second, does land use structure change have a spatial dimension related to HSR development? For the first time, the spatial dimension of urban land use as it is related to HSR development is evaluated empirically using a spatial panel regression analysis. The assessment is based on a micro-level land use data covering 285 cities for the period 2007−2015. The research findings reveal that HSR plays a significant role in promoting urban land use structure change in China. The influence of HSR is much larger than that from other types of transportation infrastructure. In addition, impacts were found to vary across different size scales of cities. In particular, the impact of HSR on change in urban land use structure was found significant in Tier 2–3 cities. Conversely, the financial constraint of local government was also confirmed to have a significant influence on land use structure change in medium and small cities (Tier 3–5 cities). Overall, the study provides evidence and implications for policy makers to improve decision-makings on land use policy reforms and guidance for future infrastructure development.

This paper examines several concepts and applications that influence city and urban development. The purpose is to explore the limits to city and urban growth. These urban expansions are reflected in the growth of Charleston SC and Portland OR through their changes in night light expression. These concepts include carrying capacity, growth or cordon boundaries, agglomeration, technological change and human ingenuity and innovation. A conclusion of this review is that history suggests that there is no strong evidence that urban growth can be limited either in scale or extent. Alternative urban futures are created with a no limits assumption due to the positive reinforcing effects of agglomeration as against the limiting assumption of controlled growth. However, technology and human ingenuity operate to produce a larger and more dispersed urban landscape. Discussion and conclusions follow this qualitative analysis.

Background There is suboptimal early initiation of breastfeeding (EIBF) with widespread prelacteal feeding in Ghana. However, studies exploring the determinants of EIBF and prelacteal feeding are limited in Ghana. The study was conducted to assess the prevalence and determinants of EIBF and prelacteal feeding in Northern Ghana. Methods This cross-sectional study was conducted among 508 mothers with infants aged 0–24 months in the Sagnarigu Municipality of Northern Ghana. The quantitative data were collected using a structured questionnaire adapted from Ghana’s demographic and health survey. Multivariate logistic regression was used to identify the independent determinants of EIBF and prelacteal feeding. Results The prevalence of EIBF and prelacteal feeding was 72% and 21%, respectively. The independent positive determinants of EIBF were partner support to breastfeed [adjusted Odds ratio (AOR): 1.86, 95% Confidence interval (CI): 1.09–3.17] and exposure to breastfeeding information during pregnancy (AOR = 1.63 (95% CI: 1.01–2.64). Lower odds of EIBF were observed among mothers from extended family (AOR = 0.62, 95% CI: 0.41–0.95). Regarding prelacteal feeding, negative determinants were having a normal weight baby (AOR: 0.50, 95% CI: 0.27–0.90), exposure to breastfeeding information during pregnancy (AOR: 0.54, 95% CI: 0.31–0.92), while experiencing delayed onset of lactation was a risk factor for prelacteal feeding practice (AOR: 2.35, 95% CI: 1.41–3.94). Conclusion In this study, EIBF was slightly higher than the 2030 global target on EIBF with widespread prelacteal feeding practice. Health programs aimed at improving EIBF should focus on the women partners, nutrition counselling, and support to mothers from the extended family. In the same vein, programs aimed at discouraging prelacteal feeding practice should also target women at risk, such as those with low birthweight babies and women experiencing delayed lactation onset.

The return to democratic dispensation and the surge to acquire political power had led to increase in violence in the Niger Delta region. This assumed different dimension for national issues as competition for scarce resources are being instigated by “inter-elite” rivalries over contradictions of ethnic diversity. These incessant struggles and the competitions had resulted into outright denial of people’s right and privileges as well as displacement of indigene and non indigene in that area. The study contended that the dynamics of internally displaced persons in the Niger Delta region were deeply rooted in the contradictions of ethnic diversity. The study is a documentary research and data were analyzed through qualitative descriptive method. Using human needs theory, the paper noted that, the need for the IDPs to be fully re-integrated into society, and the responsibility of public authorities to avoid neglect, discriminatory practices of marginalization, deprivation as well as the exploitation of the indigene non-indigene issue. It is urgent to meet the social needs of the IDPs, and their recognition and social inclusion into the society in the Rivers state, for peaceful coexistence in assuring freedom for the development of people. The study therefore recommends the following that government should ensure that specific needs of internally displaced persons are reflected in the national and local developmental plan. Received: 15 February 2021 / Accepted: 1 September 2021 / Published: 5 November 2021

This paper investigates a fundamental question related to the massive railway infrastructure development in China. What is the impact of high-speed rail (HSR) on regional economic disparity? The question is investigated from three perspectives. First, the influence of HSR on regional economic disparity is discussed theoretically from the perspective of New Economic Geography. Second, the variation in economic disparity at both the national and regional levels is investigated using three indexes: the weighted coefficient of variation, the Theil index and the Gini index. Third, the linkages between regional economic growth and HSR is measured empirically from a quantitative and qualitative perspective using an endogenous growth modelling framework with a panel data covering the period 2000–2014. The rail network density is adopted as a proxy to reflect the quantity change in rail investment. Three accessibility indicators (weighted average travel time, potential accessibility and daily accessibility) are introduced to capture the improvement of HSR transport quality. Our findings confirm that regional economic disparity has been decreased since the development of HSR. HSR has promoted regional economic convergence in China. Specifically, the positive effect of rail network density on regional economic growth is found to be significant in the East and North, whereas the positive effect of accessibility change is found to be more significant in the Middle Reaches of Yangtze River, the Southwest and the South China.

ObjectiveThe present cross-sectional study aimed to determine population-attributable risk (PAR) estimates for factors associated with inappropriate complementary feeding practices in The Gambia.DesignThe study examined the first and most recent Demographic and Health Survey of The Gambia (GDHS 2013). The four complementary feeding indicators recommended by the WHO were examined against a set of individual-, household- and community-level factors, using multilevel logistic analysis. PAR estimates were obtained for each factor associated with inappropriate complementary feeding practices in the final multivariate logistic regression model.SettingThe Gambia.SubjectsLast-born children (n2362) aged 6–23 months.ResultsInadequate meal frequency was attributed to 20 % (95 % CI 15·5 %, 24·2 %) of children belonging to the youngest age group (6–11 months) and 9 % (95 % CI 3·2 %, 12·5 %) of children whose mothers were aged less than 20 years at the time of their birth. Inadequate dietary diversity was attributed to 26 % (95 % CI 1·9 %, 37·8 %) of children who were born at home and 20 % (95 % CI 8·3, 29·5 %) of children whose mothers had no access to the radio. Inadequate introduction of solid, semi-solid or soft foods was attributed to 30 % (95 % CI 7·2 %, 38·9 %) of children from poor households.ConclusionsFindings of the study suggest the need for community-based public health nutrition interventions to improve the nutritional status of Gambian children, which should focus on sociocultural and economic factors that negatively impact on complementary feeding practices early in infancy (6–11 months).

The significance of fracturing parameters which are aquifer integrity, rock properties, thermal stress, fracturing pressure and produced water quality to alter permeability damage, cake formation and injectivity performance was highlighted in a robust improved internal filtration—hydraulic model and permeability reduction model incorporating a $$R_{\text{AT}} (c)$$ function. The studied system is an injection well multi-reservoir formations. Field data obtained from the log and field reports and improved model were used to simulate injector, fracturing and permeability damage performance. Thus, data requirements in the $$R_{\text{AT}} (c)$$ function which are rock properties, water quality, aquifer integrity, fractures rates and pressures parameters were assessed for its impact on injector performance and permeability damage simulated in MATHLAB and COMSOL multi physics environment. The profile of injector performance and damage reservoir permeability to changes in rock properties and aquifer integrity were demonstrated to have a profound influence on both fracturing phenomena. Thus, sustainable re-injection scheme was shown as a direct consequence of rock mechanics parameters, well hydraulics aquifer integrity that largely depends on the initial concentration of active constituents of the produced water as well as physic-chemical properties of the host aquifer.

Objectives Household air pollution (HAP) is one of the leading causes of respiratory illness and deaths among young children in low and lower-middle income countries. This study examines for the first time trends in the association between HAP from cooking fuel and under-five mortality and measures the potential impact of interventions to reduce HAP using Nepal Demographic and Health Survey datasets (2001-2011). Methods A total of 17,780 living children across four age-groups (neonatal 0-28 days, post-neonatal 1-11 months, child 12-59 months and under-five 0-59 months) were included and multi-level logistic regression models were used for analyses. Population attributable fractions of key risk factors and potential impact fractions assessing the impact of previous interventions to reduce exposure prevalence were also calculated. Results Use of cooking fuel was associated with total under-five mortality (OR 2.19, 95% CI 1.37-3.51, P = 0.001) in Nepal, with stronger associations evident for sub-group analyses of neonatal mortality (OR 2.67, 95% CI 1.47-4.82, P = 0.001). Higher association was found in rural areas and for households without a separate kitchen using polluting fuel for cooking, and in women who had never breastfed for all age-groups of children. PIF estimates, assuming a 63% of reduction of HAP based on previously published interventions in Nepal, suggested that a burden of 40% of neonatal and 33% of under-five mortality cases associated with an indoor kitchen using polluting fuel could be avoidable. Conclusion Improved infrastructure and behavioral interventions could help reduce the pollution from cooking fuel in the household resulting in further reduction in under-five mortality in Nepal.

Objective: Childhood obesity is rising among culturally and linguistically diverse (CALD) groups who show poor engagement in obesity prevention initiatives. We examined the barriers and facilitators to the engagement of CALD communities in obesity prevention initiatives. Methods: We used the nominal group technique to collect data from 39 participants from Vietnamese, Burmese, African, Afghani and Indian origins living in disadvantaged areas of Victoria, Australia. Data analysis revealed ranked priorities for barriers and facilitators for CALD community engagement in obesity prevention initiatives. Results: CALD parents identified key barriers as being: competing priorities in the post-migration settlement phase; language, cultural and program accessibility barriers; low levels of food and health literacy; junk food advertisement targeting children; and lack of mandatory weight checks for schoolchildren. Key facilitators emerged as: bicultural playgroup leaders; ethnic community groups; and school-based healthy lunch box initiatives. Conclusion: This study has identified several policy recommendations including: the implementation of robust food taxation policies; consistent control of food advertising targeting children; improving CALD health literacy using bicultural workers; and matching health promotional materials with CALD community literacy levels. Implications for Public Health: These recommendations can directly influence public health policy to improve the engagement of CALD communities in obesity prevention services and ultimately reduce the widening obesity disparities in Australia.

This study investigated the prevalence of psychological distress among parents in Western Sydney households and examined its relationship with household financial, family and life stressors, and potential resilience factors. As part of a longer-term study, parents from Western Sydney, New South Wales (NSW), completed computer-assisted telephone interviews (CATI) in May 2011 (N=439). Respondents were primary caregivers of at least one child (aged 4–16). Responses were weighted to reflect the Western Sydney population. Multivariate analyses were conducted to examine the relationship between parent experiences of stressor and resilience factors and reported psychological distress. Overall, 10.7% (95% CI: 7.8, 14.5) reported experiencing high/very high levels of psychological distress. Multivariate analysis indicated that financial hardship factors formed the strongest associations with psychological distress particularly housing and job security factors and, specifically, inability to meet mortgage/rent payments (OR=5.15, 95% CI: 1.74–15.25, p=0.003), poor self-rated health (OR=4.48, 95% CI: 1.88–10.64, p=0.001), adult job loss (OR=3.77, 95% CI: 1.33–10.66, p=0.013), and other family/life events (OR=2.30, 95% CI: 1.05–5.03, p=0.037). High personal resilience was common within this parent population and was a significant protective factor for high psychological distress (OR=0.14, 95% CI: 0.06–0.34, p<0.001). The findings support the development of targeted interventions to promote parent coping strategies in the context of household financial hardship.

Background: There are limited data on the association between infant and young child feeding (IYCF) practices and diarrhoea across regional India, to inform policy initiatives and advocacy. The present study examined the association between IYCF practices and diarrhoea in regional India. Method: The study used a weighted sample of 90,596 maternal responses from the 2015-16 National Family Health Survey in India. Prevalence estimates of diarrhoea by IYCF indicators were estimated for each administrative region, namely: North (n=11,200), South (n=16,469), East (n=23,317), West (n=11,512), Central (n=24,870) and North-East (n=3,228). Multivariate logistic regressions that adjust for clustering and sampling weights were used to investigate the association between IYCF and diarrhoea in regional India. The IYCF indicators include early initiation of breastfeeding, exclusive breastfeeding (EBF), predominant breastfeeding, bottle feeding, continued breastfeeding at one year, continued breastfeeding at two years, children ever breastfed and the introduction of solid, semi-solid or soft foods. Results: The prevalence of diarrhoea was lower among infants and young children who were breastfed within 1-hour of birth and those who were exclusively breastfed. Children whose mothers continued breastfeeding at one and two years, and infants who were introduced to complementary foods had a higher prevalence of diarrhoea. Early initiation of breastfeeding and EBF were protective against diarrhoea in the North, East and Central regions of India. However, predominant breastfeeding, bottle-feeding and introduction of complementary foods were risk factors for diarrhoea in Central India. Continued breastfeeding at two years was a risk factor for diarrhoea in Western India. Conclusion: Our study suggests that early initiation of breastfeeding and EBF were protective against diarrhoea in Northern, Eastern and Central India, while predominant breastfeeding, bottle feeding, continued breastfeeding at two years and introduction of solid, semi–solid or soft foods were risk factors for diarrhoea in various India regions. Improvements in IYCF practices are likely to reduce the burden of diarrhoea-related morbidity and mortality across India regions.

Background Gestational diabetes mellitus (GDM) in Fiji is a serious public health issue. However, there are no recent studies on GDM among pregnant women in Fiji. The aim of this study was to examine prevalence of, and sociodemographic factors associated with adverse neonatal outcomes among Fijian women with GDM. Methods We used cross-sectional data of 255 pregnant women with GDM who gave birth to singleton infants at Colonial War Memorial Hospital (CWMH) in Suva city. Women underwent testing for GDM during antenatal clinic visits and were diagnosed using modified International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria. Multivariable logistic regression analysis was used to investigate factors associated with neonatal outcomes. Results Women with a previous baby weighing > 4 kg were 6.08 times more likely to experience neonatal macrosomia (Adjusted odds ratio (AOR) = 6.08; 95%CI: 2.46, 15.01). Compared to unmarried women, the odds of macrosomia among married women reduced by 71% (AOR = 0.29; 95%CI: 0.11, 0.77). Compared with delivery before 38 weeks of gestation, the infants of women who delivered between 38 and 41 weeks of gestation were 62 and 86% less likely to experience neonatal hypoglycaemia and Apgar score Conclusions The study found high rates of adverse neonatal outcomes among off springs of Fijian women with GDM and showed that interventions targeting pregnant women who are overweight, had a previous baby weighing > 4 kg, had pre-eclampsia, delivered before 38 weeks of gestation, and those who booked later than 13 weeks in gestation, are needed to improve pregnancy outcomes.

This study aimed to systematically review studies that examined the prevalence of gender based violence (GBV) that included intimate partner violence (IPV) and non-IPV among women in sub-Saharan Africa (SSA). This evidence is an important aspect to work towards achieving the Sustainable Development Goals (SDG’s) target of eliminating all forms of violence in SSA. The Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) guidelines were followed. Ovid Medline, CINAHL, Cochrane Central, Embase, Scopus and Web of Science were used to source articles with stringent eligibility criteria. Studies on GBV in SSA countries that were published in English from 2008 to 2019 were included. A random effect meta-analysis was used. Fifty-eight studies met the inclusion criteria. The pooled prevalence of IPV among women was 44%, the past year-pooled prevalence of IPV was 35.5% and non-IPV pooled prevalence was 14%. The highest prevalence rates of IPV that were reported included emotional (29.40%), physical (25.87%) and sexual (18.75%) violence. The sub-regional analysis found that women residing in Western (30%) and Eastern (25%) African regions experienced higher levels of emotional violence. Integrated mitigation measures to reduce GBV in SSA should focus mainly on IPV in order to achieve the SDG’s that will lead to sustainable changes in women’s health.

Background: Several studies have linked air pollution to COVID-19 morbidity and mortality A related issue, which has received less attention but is equally imp

The prospect of co-occurrence of Influenza (Seasonal Flu) and COVID-19 is potentially a worrisome future development that could get worse if infections are co-l

This chapter examines how and to what extent there are variations in sub-regional patterns of socio-spatial interaction using a novel methodology. The methodology uses bipartite network modeling combined with spatial statistical and geographically weighted regression analysis. It provides a statistically robust approach for studying regional variations in the relationship between social and spatial interaction at different distance thresholds. The study applies the methods to the Atlanta metropolitan area using a sample of location-sharing services data. While intended as an exploratory analysis, it does provide some evidence that the association between socialization and location behavior and related distance-decay effects are not uniform in space.

This paper presents a comparison of the COVID-19 infections between a select pair of neighboring states and their border county regions where the policies of the Non-Pharmaceutical Interventions (NPI) such as Lockdown/Stay-at-Home differ. These analyses use a Difference-in-Differences (Diff-in Diff) model to test the effectiveness of NPI in mitigating COVID-19 infections at the state and border county regions between these states. The counties are in the states on the Iowa and Illinois border, the Dakotas (North and South) and Minnesota border and the Arkansas and Mississippi border. In each case the policies on each side of the border differ and the border is clearly designated by a river separation. Based on the Diff-in-Diff model output, state policies appear to make a significant difference in some of these specific border regions, at least early in the pandemic (April-June 2020). State level results are mixed reflecting spatial heterogeneity across the inter-state system.

BackgroundUnderweight, overweight, and obesity are major public health challenges among reproductive-age women of lower- and middle-income countries (including Tanzania). In those settings, obesogenic factors (attributes that promote excessive body weight gain) are increasing in the context of an existing high burden of undernutrition. The present study investigated factors associated with underweight, overweight, and obesity among reproductive age women in Tanzania.MethodsThis study used 2015-16 Tanzania Demographic and Health Survey data (n = 11735). To account for the hierarchical nature of the data (i.e., reproductive age women nested within clusters), multilevel multinomial logistic regression models were used to investigate the association between individual-level (socioeconomic, demographic and behavioural) and community-level factors with underweight, overweight, and obesity.ResultsReproductive age women who were informally employed (relative risk ratio [RRR] = 0.79; 95% confidence interval [CI]: 0.64, 0.96), those who were currently married (RRR = 0.59; 95% CI: 0.43, 0.82) and those who used contraceptives (RRR = 0.70; 95% CI: 0.54, 0.90) were less likely to be underweight. Reproductive age women who attained secondary or higher education (RRR = 1.48; 95% CI: 1.11, 1.96), those who resided in wealthier households (RRR = 2.31; 95% CI: 1.78, 3.03) and those who watched the television (RRR = 1.26; 95% CI: 1.06, 1.50) were more likely to be overweight. The risk of experiencing obesity was higher among reproductive age women who attained secondary or higher education (RRR = 1.79; 95% CI: 1.23, 2.61), those who were formally employed (RRR = 1.50; 95% CI: 1.14, 1.98), those who resided in wealthier households (RRR = 4.77; 95% CI: 3.03, 7.50), those who used alcohol (RRR = 1.43; 95% CI: 1.12, 1.82) and/or watched the television (RRR = 1.70; 95% CI: 1.35, 2.13).ConclusionOur study suggests that relevant government jurisdictions need to identify, promote, and implement evidence-based interventions that can simultaneously address underweight and overweight/obesity among reproductive age women in Tanzania.

The world tried to control the spread of COVID-19 at national and regional levels through various mitigation strategies. The most extreme of which was large scale national and regional lockdowns. One major side-effect of large scale lockdowns was the shuttering of the economy, leading to massive layoffs, loss of income and livelihood for millions of people all over the world. Lockdowns were justified in part by scientific models (computer forecast and simulations) that assumed exponential growth in infections and predicted millions of fatalities without the so called “Non-pharmaceutical intervention” (NPI). Some scientists questioned these assumptions and showed that there was no exponential growth and thus the strict NPI regime for “flattening the curve” might have been unnecessary. Regions that followed other softer mitigation strategies such as work from home, crowd limits, use of masks, individual quarantining, basic social-distancing, testing and tracing saw similar health outcomes as the ones that had stay-at-home large scale state and community lockdowns. Ultimately what kind of mitigation strategy is enforced is a political decision that is partly informed by policy analysis based on scientific models. We do not test for what levels of NPI are necessary, however we use the “inverse-fitting Gompertz function” methodology suggested by anti-lockdown advocate Dr. Levitts to estimate the rate of growth/decline in COVID-19 infections as well to determine when disease peaking occurred. Our estimates may help predict levels of future infections, which can help a region to monitor new outbreaks as the region starts the process of opening its economy. The inverse fitting function is applied to the U.S., New York and New Jersey for COVID-19 confirmed cases reported for the time period March 15, 2020 to June 15, 2020. The estimates for the rates of growth/decline are computed and used to predict underlying future infections, so that decision makers can monitor the disease threat as they open their economies. The preliminary and exploratory analysis and findings are discussed briefly and presented primarily in charts and tables.

In an earlier study, Parajuli and Haynes (Growth and Change 43:590–614, 2012) used Data Envelopment Analysis (DEA) to assess efficiency of broadband utilization across US states. They found that a number of states in the USA assumed an efficiency score of one for broadband adoption and use. While this is not unusual, the commonly used DEA methods—the Charnes, Coopers, and Rhodes and the Banker, Charnes, and Cooper extension—do not rank relative efficient decision-making units (DMUs) across the efficient frontier. The super-efficiency estimation presented here is one method that overcomes this inherent limitation and allows for ranking the efficient DMUs. This paper uses a super-efficiency method to rank states that were efficient in broadband adoption and use in the USA from 2005 through 2007.

During the pre-vaccine period, the success of containing the spread of COVID-19 depends upon how communities respond to non-pharmaceutical mitigation policies such as social distancing, wearing of masks, retail and dining constraints, crowd limitation, and shelter-in-place orders. Of these policies, shelter-in-place and social distancing are of central importance. By using county-level mobility data as a measure of a community's voluntary compliance with social distancing policies, this study found that counties who received strong state social distancing policy directives and who had a high pro-social character showed lower mobility on retail and recreation mobility and grocery and pharmacy mobility (better social distancing) after states reopened from shelter-in-place orders. Counties that experienced a longer duration of shelter-in-place orders showed higher mobility (less social distancing), implying that the duration of the shelter-in-place order deteriorated social distancing response after reopening. This may be because reopening sent a "safe" signal to these counties or resulted in a response to the pent-up demand inducing higher mobility. The results indicate that implementing shelter-in-place and social distancing policies to slow down the transmission of COVID-19 were not necessarily effective in motivating a county to reduce mobility voluntarily. A county's pro-social character and the duration of shelter-in-place order should be considered when designing COVID-19 mitigation policies.